North Carolina: Centene/Ambetter jumps back INTO ACA exchange market...

As I noted last week, insurance carriers in North Carolina were supposed to have submitted their preliminary 2019 premium rate change filings as of May 21st. Unfortunately, as I also noted last week, those "deadlines" appear to be more "guidelines" in many states, with North Carolina among them; there's no publicly-available premium change data available yet.

However, as Louise Norris notes over at, there's some interesting news afoot in the Tar Heel State:

Looking ahead to 2019

Insurers that wish to offer individual market coverage in North Carolina in 2019 had to file rates and forms by May 21, 2018. The two insurers that offer 2018 coverage in the North Carolina exchange — Cigna and Blue Cross Blue Shield of North Carolina — have both filed rate for 2019. Although the filings do show up in SERFF, they have very little publically available data at this point.

The North Carolina Department of Insurance has said that rate filing data will be made public as of July 25, for any insurers seeking rate increases of 15 percent or more. CMS will publicize all rate filing data (including proposed rate increases of less than 15 percent) in August.

Ugh. So much for May 21st. Last year BCBSNC chose to publicly reveal their rate hikes immediately upon submitting them via a blog post explaining, point blank, that Donald Trump's decision to cut off Cost Sharing Reduction (CSR) reimbursement payments was responsible for nearly all of their 2018 increase. Unfortunately, so far they haven't posted any such blog entry this year.

Here's the noteworthy tidbit for 2019:

In addition, Ambetter (Centene) has filings in SERFF for North Carolina’s 2019 individual market. Ambetter does not yet offer coverage in North Carolina, and will be new to the market, assuming their plan filings are approved. The filings include the initial applications that insurers must submit in order to become a licensed HMO in North Carolina, as well as form filings for a variety of on- and off-exchange individual market plans. The filings do not indicate where in North Carolina Ambetter is planning to enter the market, but it appears that at least some residents in North Carolina will have Ambetter as a choice when open enrollment begins in November 2018.

This is a pretty big deal for several reasons. For one thing, given the trend over the past few years of numerous carriers dropping out of the individual market, it's always welcome news when one decides to jump back in, especially in a state which only has one or two available to begin with.

More importantly, as David Anderson notes this morning...

Centene’s entry into the state will be a significant shake-up. Centene’s strategy is to consistently offer very low cost, narrow networks. Centene does not Silver Gap. It instead aggressively compresses the Silver spread between its plans while trying to have a large gap between the benchmark and the least expensive plans of its broader network competitors.

...The entry of Centene will be good for the federal government, it will be good for non-subsidized buyers, and it will be indifferent for reasonably healthy people who are buying subsidized Silver plans. It will most likely lead to higher premiums net of subsidy for people buying Bronze plans as well as people who have significant medical needs that require broad networks.

In other words, winners and losers. On the other hand, the only reason subsidized Bronze enrollees would see a net rate increase next year is because they saw an unexpected net rate decrease this year, and the biggest cost crisis by far at the moment is for unsubsidized enrollees anyway, so this sounds like it's still positive news overall.